1. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Chapter 29 Safety, Infection Control, and Hygiene

2. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Creating a Culture of Client Safety National Patient Safety Goals: –Identify patients correctly –Improve staff communications –Use medicines safely –Prevent infection –Check patient medicines (continued)

3. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Creating a Culture of Client Safety National Patient Safety Goals: –Prevent patients from falling –Help patients be involved in own care –Identify patient safety risks –Watch patients closely for changes –Prevent errors in surgery

4. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Factors Affecting Safety Age Lifestyle Sensory and perceptual alterations Mobility Emotional state

5. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Types of Accidents Client behavior Therapeutic procedure Equipment

6. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Potential Occupational Hazards Nurses at risk in workplace –Latex allergies –Work-related musculoskeletal disorders OSHA –Enforces safety standards –Cites and disciplines agencies not in compliance

7. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Infection Control Principles Pathogens –Microorganisms that produce disease Infection –Invasion and multiplication of microorganisms –Results in injury (continued)

8. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Infection Control Principles Colonization –Invasion and multiplication of microorganisms without tissue injury

9. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Chain of Infection Agent, host, and environment –Biological agents –Chemical agents –Physical agents –Susceptible host –Compromised host (continued)

10. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Chain of Infection Modes of transmission –Contact –Airborne –Vehicle –Vector-borne Break chain

11. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Normal Defense Mechanisms Nonspecific immune defense: –Skin and normal flora –Mucous membranes and sneeze, cough, and tearing reflexes –Elimination and acidic environment –Inflammation (continued)

12. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Normal Defense Mechanisms Specific immune defense: –Humoral immunity –Acquired immunity Vaccination

13. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Stages of the Infectious Process Infectious responses: –Localized Limited to defined area or single organ –Systemic Affects entire body and multiple organs (continued)

14. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Stages of the Infectious Process Incubation period Prodromal stage Illness stage Convalescent stage

15. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Emerging Infections Tuberculosis Severe acute respiratory syndrome (SARS-CoV) Hepatitis West Nile virus Viral hemorrhagic fevers Human immunodeficiency virus (HIV)

16. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Health Care-Associated Infections Acquired in hospital or other health care facilities Hospitalized clients at risk for nosocomial infections Multidrug-resistant organisms (MDROs)

17. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Hygiene Factors influencing hygienic practice: –Body image –Social and cultural practices –Personal preferences –Socioeconomic status –Knowledge

18. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Safety, Infection Control, Hygiene and the Nursing Process Assessment –Health history General health perception and management status –Physical examination Risk factors Client in inpatient setting Client in home (continued)

19. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Safety, Infection Control, Hygiene and the Nursing Process Assessment –Diagnostic and laboratory data Blood profile –Altered clotting –Anemic conditions –Leukocytosis (continued)

20. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Safety, Infection Control, Hygiene and the Nursing Process Diagnosis –NANDA statements Risk for injury Risk for infection Self-care deficits Others (continued)

21. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Safety, Infection Control, Hygiene and the Nursing Process Outcome identification and planning –Manipulate external environment to reduce risk of injury and infection –Client and caregiver education Identification of hazards Health promotion practices (continued)

22. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Safety, Infection Control, Hygiene and the Nursing Process Implementation –Raise safety awareness and knowledge –Prevent falls Restraints –Physical –Chemical Environment (continued)

23. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Safety, Infection Control, Hygiene and the Nursing Process Implementation –Prevent fire –Ensure safe operation of electrical equipment –Reduce exposure to radiation –Prevent poisoning –Reduce noise pollution (continued)

24. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Safety, Infection Control, Hygiene and the Nursing Process Implementation –Ensure asepsis Medical –Reduces number, growth, and spread of microorganisms –Clean technique –Hand hygiene (continued)

25. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Safety, Infection Control, Hygiene and the Nursing Process Implementation –Ensure asepsis Surgical –Eliminates microorganisms and spores –Sterile technique –Sterile gloves –Surgical attire –Surgical hand antisepsis –Gown and closed glove (continued)

26. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Safety, Infection Control, Hygiene and the Nursing Process Implementation –Reduce or eliminate infectious agents Cleansing Disinfection Sterilization Home health care Disposal of infectious waste Sharps-related hazards (continued)

27. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Safety, Infection Control, Hygiene and the Nursing Process Implementation –Practice standard and isolation precautions Contact Droplet Airborne (continued)

28. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Safety, Infection Control, Hygiene and the Nursing Process Implementation –Employ alternative therapies Herbal baths –Bath for specific body part –Full body bath Herbs for infections (continued)

29. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Safety, Infection Control, Hygiene and the Nursing Process Implementation –Provide for client bathing needs Cleaning baths –Shower –Tub bath –Self-help bath –Complete bed bath –Partial bath (continued)

30. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Safety, Infection Control, Hygiene and the Nursing Process Implementation –Provide for client bathing needs Therapeutic bath –Hot or warm water tub bath –Cool or tepid bath –Sitz bath (continued)

31. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Safety, Infection Control, Hygiene and the Nursing Process Implementation –Provide clean bed linen Unoccupied Occupied –Provide skin care Perineal care Back rubs (continued)

32. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Safety, Infection Control, Hygiene and the Nursing Process Implementation –Provide foot and nail care –Provide oral care Fluoride Flossing Brushing Care for unconscious client (continued)

33. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Safety, Infection Control, Hygiene and the Nursing Process Implementation –Provide hair care Brushing and combing Shampooing Shaving Mustache and beard care (continued)

34. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Safety, Infection Control, Hygiene and the Nursing Process Implementation –Provide eye, ear, and nose care Eyes –Contact lenses Ears –Hearing aids Nose (continued)

35. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Safety, Infection Control, Hygiene and the Nursing Process Evaluation –Client free from injury –Client free from infection –Self-care needs met